CCS Medical Practice, PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

CCS MEDICAL PRACTICE, PLLC

Practice address

17 Southdown Road
Huntington, NY 11743

Phone

(631) 923-2139

NPI assigned

Feb 21, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Kennedy, D.O.

Title

Owner

Phone

(631) 923-2139

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1265857643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SOUTHDOWN ROAD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "301-809-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SOUTHDOWN ROAD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-923-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCS MEDICAL PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-923-2139",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NY",
            "license": "7175553",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelina Castillo
• Sara Cataldo, P.A.
• Stefani Lauren Catanzano
• Joanne Catsounis, NP
• CC NP in Psychiatry PLLC
• Lawrence Ira Chalif, M.D.
• Lewey Chan, PHARM.D.
• Johanna Lynn Chang, MS, CCC-SLP
• Charles Craig Home Care Inc
• Barbara A. Charles, CNM

• Nurse Practitioner in Huntington, NY
• Providers in Huntington, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.